The client has metastatic bone pain from cancer with nausea and vomiting after receiving opioid analgesia by IV. Which does the nurse implement to manage the client's pain effectively without nausea and vomiting?

Question

1. Dispense the opioid 30 minutes after providing food.
2. Combine the opioid with an antiemetic or antihistamine.
3. Collaborate with provider for around-the-clock analgesia.
4. Replace analgesic with nonsteroidal anti-inflammatory agent.

Answer 1

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3. Metastatic bone pain can be very difficult to control for a client with cancer. The nurse collaborates with the provider to convert IV opioid administration to around-the-clock (ATC) because ATC administration maximizes the pain relief and minimizes most side effects and drug toxicity. This is a reasonable method to help prevent the client's nausea and vomiting in addition to providing effective pain man-agement as recommended by the American Pain Society.
1. Administering opioids with food is an effective technique to avoid nausea and vo-miting but usually only when the opioid is given by mouth.
2. Administering an antiemetic with an opioid analgesic is a reasonable method of managing the client's nausea and vomiting. ATC dosing is superior to intermittent administration of an opioid because it decreases the risk of the adverse effects from the opioid, including nausea, vomiting, and respiratory depression, and decreases the need to administer another medication to manage adverse effects. Several antihista-mines effectively relieve nausea and vomiting.
4. The nurse uses a nonsteroidal anti-inflammatory agent (NSAID) to augment opioid analgesia for bone pain; however, the nurse administers the NSAID in combination with the opioid.